Individual
SUSAN V PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11551 TANGLEWOOD LAKE CIRCLE, SUITE 2, ANCHORAGE, AK 99516-1304
(907) 562-7745
(907) 562-7808
Mailing address
PO BOX 241769, ANCHORAGE, AK 99524-1769
(907) 770-2380
(907) 770-2341
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
67
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT0577
—
AK
Enumeration date
04/13/2006
Last updated
09/02/2010
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